Amphetamines (Includes Obezine) ↔ Cardiovascular

The use of amphetamines and amphetamine-like drugs is contraindicated in patients with advanced arteriosclerosis, symptomatic or unstable cardio- or cerebrovascular disease, moderate to severe hypertension, or hyperthyroidism. Like other sympathomimetic amines, amphetamines may cause cardiovascular adverse effects such as palpitation, tachycardia, cardiac arrhythmias, and elevation of blood pressure. Rarely, cardiomyopathy manifested as ventricular hypertrophy and/or congestive heart failure has been reported during chronic amphetamine use. In addition, sudden death has been reported in association with amphetamine therapy at usual dosages in children with structural cardiac abnormalities. In general, amphetamines should not be used in patients with structural cardiac abnormalities. If not otherwise contraindicated, therapy with amphetamines should be administered cautiously in patients with a current or past history of cardiovascular or cerebrovascular disease.

Amphetamines (Includes Obezine) ↔ Glaucoma

Severe Potential Hazard, Moderate plausibility

Applies to: Glaucoma/Intraocular Hypertension

The use of amphetamines and amphetamine-like drugs is contraindicated in patients with narrow-angle glaucoma or anatomically narrow angles. Like other sympathomimetic amines, amphetamines can induce transient mydriasis. In patients with narrow angles, pupillary dilation can provoke an acute attack of angle-closure glaucoma. If possible, these agents should also be avoided in patients with other forms of glaucoma, since mydriasis may occasionally increase intraocular pressure.

Cns Stimulants (Includes Obezine) ↔ Agitation

Severe Potential Hazard, High plausibility

Applies to: Psychosis, Anxiety/Stress, Neurosis

The use of central nervous system (CNS) stimulants is contraindicated in patients with marked agitation and/or anxiety, since these symptoms may be aggravated. CNS stimulants may also exacerbate symptoms of behavior disturbance and thought disorder in psychotic patients, particularly children. Therapy with CNS stimulants should be administered cautiously in patients with a history of psychosis or a predisposition to agitated states.

Cns Stimulants (Includes Obezine) ↔ Cardiac Disease

The use of CNS stimulants is contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc. Sudden death has been reported in adults and children taking CNS stimulant treatment. Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias and other symptoms have been reported in adults under treatment. A careful assessment of the cardiovascular status should be done in patients being considered for treatment. This includes family history, physical exam and further cardiac evaluation (EKG and echocardiogram). Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.

References

Cns Stimulants (Includes Obezine) ↔ Hypertension

Severe Potential Hazard, Moderate plausibility

Applies to: Hypertension

CNS stimulant medications have shown to increase blood pressure and their use is contraindicated in patients with severe hypertension. Caution should be used when administering to patients with preexisting high blood pressure and other cardiovascular conditions. All patients under treatment should be regularly monitored for changes in blood pressure and heart rate.

References

Cns Stimulants (Includes Obezine) ↔ Liver Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease

In general, CNS stimulants are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with CNS stimulants should be administered cautiously in patients with moderate to severe liver disease, and the dosage should be adjusted accordingly. Additionally, postmarketing reports have shown that atomoxetine can cause severe liver injury. Laboratory testing should be done at the first sign or symptom of liver dysfunction (jaundice, dark urine, upper quadrant tenderness) and treatment should be discontinued in patients with evidence of liver injury.

References

Cns Stimulants (Includes Obezine) ↔ Pulmonary Hypertension

Severe Potential Hazard, Moderate plausibility

Applies to: Valvular Heart Disease, Syncope

The use of some CNS stimulants has been associated with an increased risk of developing pulmonary hypertension, a rare but fatal disorder. The onset or aggravation of exertional dyspnea, or unexplained symptoms of angina pectoris, syncope, or lower extremity edema suggest the possibility of occurrence of pulmonary hypertension. Under these circumstances, treatment must be immediately discontinued, and the patient should be evaluated to confirm diagnosis. Caution should be exercised in patients with preexisting valvular heart disease or history of pulmonary hypertension. These drugs are not recommended in patients with known heart murmur or valvular heart disease.

Major

Cns Stimulants (Includes Obezine) ↔ Seizure Disorders

Severe Potential Hazard, Moderate plausibility

Applies to: Seizures

Due to general central nervous system stimulation, therapy with CNS stimulant drugs may cause seizures. These drugs may lower the convulsive threshold in patients with prior history of seizures or EEG abnormalities, and very rarely in patients with no previous history of seizures. Therapy with CNS stimulants should be used with caution in patients with or predisposed to seizures. If seizures appear, therapy should be discontinued.

References

Cns Stimulants (Includes Obezine) ↔ Substance Abuse

Severe Potential Hazard, High plausibility

Applies to: Alcoholism, Drug Abuse/Dependence

Central nervous system (CNS) stimulants, especially amphetamines, have significant potential for habituation and abuse. Tolerance, psychological dependence and severe social dysfunction can develop after prolonged use. Frank psychotic episodes may also occur in association with chronic intoxication. Therapy with CNS stimulants should be administered cautiously, if at all, in patients with a history of alcohol or substance abuse. The use of amphetamines is considered by manufacturers to be contraindicated in such patients.

Cns Stimulants (Includes Obezine) ↔ Diabetes

Moderate Potential Hazard, Moderate plausibility

Applies to: Diabetes Mellitus

Insulin requirements in patients with diabetes mellitus may be altered in association with the use of some centrally-acting anorexiants and concomitant dietary restrictions. Caution and monitoring is recommended in patients with diabetes.

Moderate

Cns Stimulants (Includes Obezine) ↔ Psychiatric Disorders

Moderate Potential Hazard, Moderate plausibility

Applies to: Psychosis, Depression

The use of CNS stimulants can cause psychotic or maniac symptoms, suicidal ideation, aggression and can exacerbate symptoms of behavior disturbance and thought disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders, and all patients should be monitored closely, specially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. All patients receiving treatment should be screened for bipolar disease prior to initiation. If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. CNS stimulants are contraindicated in patients with marked agitation or anxiety.

References

Cns Stimulants (Includes Obezine) ↔ Renal Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

Overall CNS stimulants should be administered with caution in patients with significantly impaired renal function as the reduction in the rate of elimination may alter the therapeutic response. The dosage should be adjusted accordingly.

References

Cns Stimulants (Includes Obezine) ↔ Tics

Moderate Potential Hazard, High plausibility

Applies to: Tic Disorder

Central nervous system (CNS) stimulants have been reported to exacerbate Tourette's syndrome and other motor and phonic tics. Therapy with CNS stimulants, if necessary, should be administered cautiously in patients with tic disorders or family history of Tourette's syndrome. The manufacturers of the CNS stimulants, methylphenidate (racemic) and dexmethylphenidate (the more pharmacologically active d-enantiomer), consider their use to be contraindicated in such patients.

Obesity Drugs (Includes Obezine) ↔ Diabetics

Moderate Potential Hazard, High plausibility

Applies to: Diabetes Type 2

Obese, type 2 diabetic patients who achieve weight loss may demonstrate improved metabolic control of their disease as a result of their reduced weight. Therefore, patients with type 2 diabetes mellitus should be monitored during weight-reduction therapy (or therapy that may be expected to induce significant weight loss as a secondary effect) for hypoglycemia and reduced need for oral hypoglycemic medication or insulin, and the dosages of these agents adjusted accordingly. Patients should be apprised of the risk of hypoglycemia and be alert to potential signs and symptoms such as headache, dizziness, drowsiness, nervousness, confusion, tremor, hunger, weakness, perspiration, and palpitation.

Do not stop taking any medications without consulting your healthcare provider.

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